Total Pulpotomy With Two Repair Cements in Hypomineralized Teeth

Overview

BRIEF SUMMARY The goal of this clinical trial is to learn whether two materials used during pulpotomy treatment can reduce pain after treatment in children with molar-incisor hypomineralization (MIH), deep tooth decay, and irreversible pulpitis in permanent molars. The main questions it aims to answer are: * Does the type of material used during pulpotomy affect pain after treatment? * Does the type of material affect pain when chewing during the first week after treatment? Researchers will compare Mineral Trioxide Aggregate (MTA) and CIMMO DTA® to determine whether one material provides better pain control after pulpotomy treatment. Participants will: * Attend a dental examination to confirm eligibility for the study. * Receive pulpotomy treatment on an affected permanent molar using either MTA or CIMMO DTA®. * Return for follow-up evaluations after treatment. * Record pain levels using a child-friendly pain scale during the first week after the procedure. The information collected in this study may help identify effective and accessible treatment options for children with MIH and irreversible pulpitis while preserving permanent teeth and reducing the need for more invasive procedures.

Molar-incisor hypomineralization (MIH) is a developmental enamel defect affecting one or more permanent first molars, frequently associated with affected incisors. The condition is characterized by qualitative defects in enamel mineralization, resulting in increased porosity, post-eruptive enamel breakdown, hypersensitivity, and a higher risk of rapid caries progression. These clinical characteristics often complicate restorative treatment and may lead to early pulpal involvement in affected teeth. The management of deep carious lesions and pulp inflammation in MIH-affected teeth remains a clinical challenge. Due to structural alterations in enamel and dentin, these teeth may present increased sensitivity, difficulty achieving adequate anesthesia, and a greater likelihood of restorative failure. Consequently, preserving pulpal vitality while controlling symptoms is a priority in pediatric dental care. In recent years, vital pulp therapy has gained increasing acceptance as a conservative treatment approach for permanent teeth diagnosed with pulp inflammation. Among these procedures, full pulpotomy has demonstrated favorable clinical and radiographic outcomes, even in cases previously considered candidates for conventional root canal treatment. This approach aims to maintain the vitality and function of the remaining radicular pulp tissue, supporting continued tooth preservation and reducing treatment complexity. Calcium silicate-based biomaterials play a central role in the success of pulpotomy procedures because of their bioactivity, sealing ability, and capacity to stimulate hard tissue formation. Mineral Trioxide Aggregate (MTA) is considered a reference material for vital pulp therapy; however, its cost and handling characteristics may limit widespread use in some clinical settings. CIMMO DTA® is a calcium silicate-based material that has shown promising biological and physicochemical properties and may represent a more accessible alternative. Nevertheless, clinical evidence comparing its performance with established materials in teeth affected by MIH remains limited. This randomized clinical trial was designed to contribute to the evidence base regarding the management of pulpally involved MIH-affected permanent molars. By evaluating postoperative outcomes following full pulpotomy performed with different calcium silicate-based materials, the study seeks to generate clinically relevant information that may support treatment decision-making and expand access to conservative therapeutic options for children and adolescents. The results of this study may contribute to improving the management of MIH-related complications, reducing the burden of dental pain, supporting tooth preservation, and strengthening evidence-based approaches in pediatric dentistry and vital pulp therapy.